Pleural Pathology Flashcards
(26 cards)
describe the structure of the normal mesothelium
single layer of mesothelial cells which secrete hyaluronic acid and rich mucous pleural fluid
what are various causes of pleural inflammation
primary inflammatory diseases infections pulmonary infarction emphysema pleural neoplasms therapeutic (pleurodesis) latrogenic (radiotherapy)
what is the paythogensis of pleural fibrosis
secondary to pleural inflammation the fibrosis prevents expansion and compresses the lung - breathlessness and adhesion
what is pleural decortication
removing fibrous tissue to improve respiration
what is a classical marker in the lungs of asbestos exposure
pleural fibrous plaques
what is the difference between parietal pleural fibrous plaques and diffuse pleural fibrous plaques
PPFP - low level exposure to asbestos and asymptotic
DPFP - high level asbestos exposure
symptomatic with breathlessness
what are three types of pathological fluids in the pleural cavity
pus - empyema or pyothroax secondary to pneumonia
blood - haemothroax - trauma
bile - chylothroax - trauma
liquid or serous fluid in the pleural cavity is called what
pleural effusion
what is a transudate pleural effusion (PE) and its causes
low protein and lactate hydrogenase
low capillary oncotic pressure or high hydrostatic pressure pushes fluid into pleura
may be due to left ventricular failure or renal failure = backlog into pulmonary circulation
what is an exudate pleural effusion (PE) and its causes
high protein and lactate hydrogenase
caused by inflammation without infection
what are the signs and symptoms of plural effusion
breathlessness, pain
dull to percuss and reduced breath sounds
what is the treatment of pleural effusion
breathlessness - remove the fluid by aspriation or pleurodesis
treat underlying cause
what is gas or air in the pleural cavity called
pneumothorax
what are the differences between the 3 types of pneumothorax
open - chest wall perforation in trauma - sucking chest wound - air in during inspiration which reduces lung expansion
closed - lung perforation from ruptured emphysematous bullae - inflammation
tension - open or closed are valvular so let air in but not out which compresses mediastinum structures such as the heart or contralateral lung
what are the common signs and symptoms of pneumothorax
breathlessness and chest pain, cyanosis, tachycardia, contralateral trachea deviation
percussion - hyperressonant
auscultation - reduced breath sounds
what are the various treatment for pneumothorax
valvular aspiration
if one - cover chest wound
if recurrent - pleurodesis
what are the differences between primary and secondary neoplasms
primary - benign/low grade = rare or malignant mesothelioma
secondary - carcinomas from breast or lung
what by definition is a malignant mesothelioma
a neoplasm of mesothelial cells that line serous cavities - pleura peritoneum pericardium or tunica vaginalis
who are most at risk to malignant mesothelioma
men
what is the difference between an early mesothelium and an advanced one
early - large pleural effusion
advanced - spread to other cavities and metastasise
what is the histology of malignant neoplasm of the pleura
tubulopapillary epithelia and spindle cell sarcomatoioid
what is the cause of malignant mesothelioma
asbestos - 80-90% and develops over 60 years
thoracic irradiation or BAp1 mutations
what are the three types of asbestos
amphibole - blue (crocidolite), brown (amosite)
serpentine - white (chrysolite)
which types of asbestos are the mis oncogenic
amphiboles - mainly crocidolite - persists in the lungs
